276 
TREATMENT OF UMBILICAL HERNIA. 
fastened by two rollers. The plate has a rounded prominence about 2 
inches high on the side next the abdomen, which fits into the hernial ring and 
keeps back the contents. This truss is worn for four to eight days, when 
swelling of the ring occurs, and it may be removed to see whether the hernia 
returns. Should this happen, the parts can either be dressed all over with 
diluted nitric acid or be fired, after which a second bandage is applied, whose 
girth carries a similar plate 14 inches long and 9 inches broad, covered with 
a tarred linen compress. Three days later Martin blisters the parts with 
cantharides oil to assist the separation of the eschar, which is said to occur 
eight days afterwards. The girth is then loosened a little and reapplied, after 
smearing the rupture with tar. Martin states having cured umbilical herniae 
in this way within twenty days. 
Without doubt the pressure of the bandage on the inflamed hernial sac 
assists its contraction and the return of the contents, but necrosis of the sac 
is apt to occur, and the truss must, therefore, be frequently examined. 
Imminger recommends injecting subcutaneously 1 to 1-| ounces of a 15 per 
cent, salt solution about an inch in front of, and also behind the rupture. One 
injection is said to be sufficient to cure small herniae in four to six weeks. 
Thickening remains for some time, but this is thought to close the ring. 
Lucet injects from 2 to 7 ounces of a similar solution all round the ring. 
These methods assist return of hernial contents to the abdominal cavity 
by the swelling they cause, an action which is continued by the subse¬ 
quent cicatricial contraction of the skin. Acids are preferable to 
blistering ointments, as, e.g., cantharides ; and Hupe states that inguinal 
herniae in foals can be cured with certainty during the first six months 
of life by smearing with acid, sulphur. 
This treatment is only suitable to small herniae in young animals ; in 
larger herniae it is of no value, and Degive restricts its use to cases where 
not more than two fingers can be introduced into the hernial opening, 
and where the sac is not greater than a hen’s egg. Where irritants have 
failed, the hernial contents often become adherent to the sac, and may 
later cause difficulty in operative treatment. 
(8) The following methods of radical treatment have been employed:— 
(a) Simple or multiple ligation of the sac. This is best performed in 
spring or autumn and at a time when the animal is otherwise in good 
health. The limits of the sac should be marked before -casting. In 
herniae not possessing too broad a base the parts are first carefully 
replaced (the animal having been placed on its back and the hind legs 
bent), and a ligature passed around the neck of the sac. Esser recom¬ 
mends for this purpose the elastic ligature. When, ten to twelve days 
later, this falls off, together with the hernial sac, a cicatrix has formed 
in the position of the latter, which prevents prolapse of the bowel. The 
elastic ligature should, however, not be drawn tight enough to cut 
rapidly. To prevent its sliding off, a strong needle may be passed 
through the sac below it. 
Degives takes up as much as possible in the ligature, and draws this 
quite tight. According to him the method is very successful in ruptures 
